OBJECTIVES To compare the association of home (HBP), ambulatory (ABP) and office blood pressure (OBP) measurements with preclinical organ damage in young individuals. METHODS Individuals referred for elevated blood pressure and healthy volunteers aged 6-25 years were evaluated with OBP (2-3 visits), 7-day HBP and 24-h ABP monitoring. Organ damage was assessed by echocardiographic left ventricular mass index (LVMI), carotid ultrasonography [intima--media thickness (IMT)] and pulse wave velocity (PWV) using piezo-electronic or oscillometric technique. RESULTS Analysis included 251 individuals (mean age 14 ± 3.9 years, 70.9% men 31.1% children, 54.6% adolescents, 14.3% young adults) of whom 189 had LVMI, 123 IMT and 198 PWV measurements. Office, ambulatory and home hypertension was diagnosed in 29.5, 27.1 and 26.3% of participants. The agreement of OBP with ABP was 74.5% (kappa 0.37) and HBP 76.1% (kappa 0.41), with closer agreement between HBP and ABP (84.9%, kappa 0.61). LVMI gave comparable correlations with systolic OBP, 24-h ABP and HBP (r = 0.31/0.31/0.30, all P  less then  0.01). The same was the case for IMT (0.33/0.32/0.37, all P  less then  0.01) and piezo-electronic PWV (0.55/0.53/0.52, all P  less then  0.01), whereas oscillometric PWV gave stronger correlations with OBP than ABP or HBP. In linear regression analysis, the variation of LVMI was determined by night-time ABP, of IMT by HBP and of PWV by OBP and 24-h ABP. CONCLUSION These data suggest that in young individuals, target organ damage is mainly determined by out-of-office rather than office BP. Home and ambulatory BP give comparable associations with preclinical organ damage.BACKGROUND Arterial stiffness is tightly linked to hypertension. Sex differences in hypertension and arterial stiffness have already been established, yet the role of sex hormones is not precisely defined. This study examined age and sex differences of arterial wave reflection and associations with endogenous and exogenous sex hormones in women. METHODS Pulse wave analysis was performed with an oscillometric device in 590 male and 400 female participants of the Berlin Aging Study II. Participants have been recruited from two age-strata, 22-35 years and 60-82 years. Data on exposures and potential confounders, including medication, have been collected at baseline visit. RESULTS Aumentation index (AIx) and pulse wave velocity increased with age. Mean AIx was higher in women than in men. Multivariable regression analysis showed a positive association between use of oral contraceptive pills (OCPs) and AIx controlling for confounders (age, BMI, current smoking, central blood pressure), with a significantly higher mean AIx in OCP-users compared with nonusers (mean group difference 4.41; 95% confidence interval 1.61-7.22). Per quartile decrease in estradiol level AIx increased by 1.72 (95% confidence interval 0.43-3.00). In OCP users endogenous estradiol was largely suppressed. CONCLUSION The findings suggest important sex differences in measures of arterial wave reflection, with a higher mean AIx observed in women compared with men. OCPs may promote the development of hypertension by increasing AIx. Suppressed endogenous estradiol levels may be responsible for this increased wave reflection due to increased vasotonus of the small and medium arteries.OBJECTIVES Accurate assessment of mean arterial pressure (MAP) is crucial in research and clinical settings. Measurement of MAP requires not only pressure waveform integration but can also be estimated via form-factor equations incorporating peripheral SBP.  https://www.selleckchem.com/products/zidesamtinib.html  SBP may increase variably from central-to-peripheral arteries (SBP amplification), and could influence accuracy of form-factor-derived MAP, which we aimed to determine. METHODS One hundred and eighty-eight patients (69% men, age 60 ± 10 years) undergoing coronary angiography had intra-arterial pressure measured in the ascending aorta, brachial and radial arteries. Reference MAP was measured by waveform integration, and form-factor-derived MAP using 33 and 40% form-factors. RESULTS Reference MAP decreased from the aorta to the brachial (-0.7 ± 4.2 mmHg) and radial artery (-1.7 ± 4.8 mmHg), whereas form-factor-derived MAP increased (33% form-factor 1.1 ± 4.2 and 1.7 ± 4.7 mmHg; 40% form-factor 0.9 ± 4.8 and 1.4 ± 5.4 mmHg, respectively). Form-factor-derived for accurate assessment of MAP in research and clinical settings.OBJECTIVE The 2018 European Society of Cardiology/European Society of Hypertension Guidelines for the management of arterial hypertension raised the need for evidence to support the use of single-pill combination (SPC) therapy in preference to free-dosed therapy for hypertension. This systematic rapid evidence assessment sought to determine if initiating SPC therapy improves adherence, blood pressure (BP) control and/or cardiovascular outcomes vs. initiation of free-dose combination therapy. METHODS Rapid evidence assessment conducted in MEDLINE, EMBASE, and Cochrane Library (1 January 2013-11 January 2019) to identify studies investigating SPC therapy for adults with hypertension. Information on adherence/persistence, BP lowering/goal attainment, and cardiovascular outcomes/events were extracted via two-phase screening process. Studies not focusing on adherence, persistence, or compliance with SPC therapy were excluded. Methodological quality was assessed using appropriate scales. RESULTS Of 863 citations, 7o determine if the increased adherence/persistence seen in patients on SPC regimen leads to improved BP control and/or cardiovascular outcomes. The issue of a potential danger of antihypertensive drugs related to cancer susceptibility is currently generating a major debate in the scientific community, concerns in the public and emphasized interest from the media. The present article is a thorough review of what is known on the various classes of antihypertensive drugs concerning the risk of developing different neoplasms and about the suggested pathophysiological mechanisms, whenever available. The main limitations of evidence derived from studies currently available in this setting are also discussed, high-lightening the need for newly developed approaches to generate more accurate recommendations and informed advice for physicians.